Reversing Type 2 Diabetes

Reversing diabetes is a term that usually refers to a significant long-term improvement in insulin sensitivity in people with type 2 diabetes

People with type 2 diabetes that are able to get their HbA1c below 42 mmol/mol (6%) without taking diabetes medication are said to have reversed or resolved their diabetes. This also known as putting diabetes into remission.

Loss of body weight can be particularly beneficial in helping to reverse the progression of diabetes.

With time and dedication, type 2 diabetes can be reversed and the results can be very rewarding, with less tiredness and better all-round health.

If you think you need to come off your diabetes medication, ensure you speak to your healthcare team before doing so.

Understanding how diabetes progresses

The most common cause of type 2 diabetes is obesity-related, which generally follows a vicious cycle pattern:

Diet high in calories -particularly if high in refined carbohydrates.

Insulin levels in the bloodstream rise to cope with the high- and quick-acting carb intake.

Weight is gained around the belly (central or truncal obesity).

Consistently high insulin levels lead to the body’s cells becoming resistant to insulin and commonly lead to weight gain.

High insulin levels also increase weight gain.

Insulin resistance leads to an increase in blood sugar levels, particularly after meals.

High sugar levels lead to feelings of lethargy and high insulin levels lead to increased hunger.

Hunger often leads to overeating and lethargy, with less physical activity being taken.

Overeating, less activity and high insulin levels all lead to further weight gain and more insulin resistance.

Consistently high demand on the pancreas to produce extra insulin leads to damage of the pancreas’ insulin-producing beta cells.

Beta cell damage results in the body struggling to produce enough insulin, and steeper rises in blood sugar levels leads to more recognisable symptoms of diabetes, symptoms of diabetes, such as thirst and a frequent need to urinate

Breaking the progressive cycle of type 2 diabetes

To reverse diabetes, you need to be able to break this cycle by taking the strain off your insulin-producing cells.

Low-carbohydrate diets

Low-carbohydrate diets are known for lowering the amount of insulin the body needs to produce, resulting in less insulin resistance. [175]

A study published in 2014 by the Second University of Naples showed that a low-carbohydrate Mediterranean diet was able to achieve significant rates of remission in people with type 2 diabetes. After one year of following the diet, 15% of participants achieved remission and, after six years, 5% had achieved remission on the diet – a stunning achievement.

By comparison, low-fat diets were not as effective in the study. After one year, 4% of participants on a low-fat diet had achieved remission and, after six years, 0% of participants had achieved remission.

Reversal of diabetes refers to type 2 diabetes. Type 2 diabetes has traditionally been viewed as a condition which gets progressively worse over time. In more recent years, there has been more evidence showing that people can reduce the severity of diabetes to halt and even reverse its progression.

Type 2 diabetes is characterised by the body struggling to respond to its own insulin. As a result, the body needs to produce more insulin to bring down glucose levels.

Research from the Joslin Diabetes Centre states that if the body struggles to keep blood glucose levels steady, the cells which produce insulin will begin to lose their ability to produce insulin. If too many insulin producing cells lose their ability to function, insulin will need to be injected to keep blood glucose levels stable.

Researchers have been able to show that diabetes can be reversed by Bariatric surgery resulting in significant weight loss and very low calorie diets.

These methods have enabled a significant number of study participants with type 2 diabetes to come off diabetic medication. Researchers have hypothesised that the improvement in blood glucose control, as a result of weight loss, may be related to a loss of fat from around organs such as the liver and pancreas.

If you are obese, you may qualify for weight loss surgery. If weight loss surgery is not an option, your doctor may help you to commence a very low calorie diet.

Very low calorie diets are regarded as extreme diets and these should not be undertaken without the support of your health team.

Very low-calorie diets

In 2011, a study was published by researchers at Newcastle University showing that an 8-week 800 kcal per day diet was able to achieve remission from diabetes in seven of the 11 participants that took part. The diet included around 600 kcal from meal shakes and around a further 200 kcal from non-starchy vegetables. [174]

The trial used MRI scans and showed that the reversal of diabetes appeared to be correlated with significant reductions in fat storage within the liver and pancreas.

Currently, Newcastle University are running a study involving 32 participants. The participants were put on a similar diet for a similar length of time and then followed a low calorie weight maintenance diet.

The participants will be reviewed for at least two years to see how many of the participants can maintain diabetes remission over this period.

Initial results show that 40% of participants had achieved and maintained remission from type 2 diabetes six months after completing the diet.

A VLCD is regarded as an extreme form of diet and therefore should be undertaken with care. If you are interested in following a VLCD, it is important that you first speak with your doctor to ensure the diet is safe for you to follow.

In addition to the results seen in clinical trials, a number of anecdotal reports from patients show VLCDs to be successful at reversing diabetes to varying degrees. Read more on the low calorie diet forum

Exercise

Exercise helps the body to become more sensitive to its insulin. In combination with a healthy diet, exercise can reduce the demand for insulin in the body and therefore help reverse diabetes.

There is a phrase that says ‘you can’t outrun a bad diet’ and there is a lot of truth in this. The people that have used exercise to reverse their diabetes have done so by combining exercise with healthy eating.

There have been a number of anecdotal accounts showing exercise to be linked with diabetes remission.

A study published in 2015 showed that 67% of participants were able to achieve partial remission of their type 2 diabetes having taken part in a six-month diet and exercise program. The participants in this study were newly diagnosed with type 2 diabetes.

Bariatric surgery

A 2010 study showed that, three years after gastric bypass surgery, 72% of participants with type 2 diabetes had achieved remission. [176], and a 2013 study reported that 24% of participants with type 2 achieved remission six years after receiving gastric bypass surgery. [177]

Gastric bypass surgery delivers the most impressive long-term remission rates but carries a risk of complications during and following surgery. It is a permanent procedure and necessitates a change to how you eat meals.

During gastric bypass surgery, the stomach is made much smaller, and only small meals can eaten following surgery. Additionally, nutritional supplements will need to be taken for the rest of one’s life.

Bariatric surgery and remission in the news:

Is it possible to reverse type 1 diabetes?

At the moment, type 1 diabetes cannot be reversed. Type 1 diabetes is an autoimmune disease, and reversing it would require a method of preventing the body’s immune system from attacking its own insulin-producing cells.

Research is currently trying find a type 1 diabetes vaccine which could help to one day reverse the condition.